Preserved Kidney Volume in Living Kidney Donors: Correlation With 2 Year Renal Function Using CKD-EPI Equation to Predict Remaining GFR

A. Khalil,¹ M. Yaqub,¹ T. Taber,¹ J. Powelson,¹ C. Sundaram,¹ W. Goggins,¹ D. Mishler,¹ M. Mujtaba,¹ A. Diez,² A. Sharfuddin.¹

¹Indiana University
²Ohio State University, Columbus.

Meeting: 2015 American Transplant Congress

Abstract number: B174

Keywords: Donation, Kidney transplantation, Laparoscopy, Renal function

Session Information

Session Name: Poster Session B: Living Donor Issues 1

Session Type: Poster Session

Date: Sunday, May 3, 2015

Session Time: 5:30pm-6:30pm

Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

Background: The aim of our study was to evaluate whether preserved kidney volume correlates with donor renal function at 2-years post-donation using the CKD-EPI eGFR equation. The CKD-EPI equation is proposed to be more accurate than the MDRD eGFR equation at higher GFRs.

Methods: Demographic and renal function data of living donors who underwent laproscopic living nephrectomy between January 2008 and November 2012 were retrospectively reviewed. All donors underwent computed tomography (CT) with an estimation of kidney volumes. Preserved Kidney Volume (PKV) was adjusted to Body Surface Area (BSA). Estimated glomerular filtration rate was calculated for pre-donation and at 2-year post-donation by using the CKD-EPI equation.

Results: A total of 260 donors were studied of which 208 (80%) had 2 year follow up data available. The median age was 38.7 years, and median adjusted PKV was 180.6ml/1.73m²(IQ range 159.9-205.8). There were 36.5% Right-sided nephrectomies with a median PKV/total volume ratio of 50.8% (IQ 49.4-52.8). There was a correlation of pre-donation total kidney volume with pre-donation eGFR (r=0.243;p<0.01) and 24hour measured creatinine clearance (r=0.466;p=<0.001). Median pre-donation eGFR(CKD-EPI) was 102.8 ml/min/1.73m² (IQ 88.8-112.7) , and 2yr eGFR (CKD-EPI) was 62.4ml/min/1.73m² (IQ 54.8-73.2). The median absolute drop in eGFR was 33.2ml/min/1.73m² (IQ25.5-44.1), with a median % change of 31.7% (IQ12.5-40.8).

The proportions of donors with 2-year eGFR(CKD-EPI) >90, 60-89, 45-59 and < 45ml/min/1.73m² were 10.0%, 45.6%, 37.1% and 7.2% respectively. Predictors of 2yr (CKD-EPI) eGFR were assessed by multiple linear regression analysis. Pre-donation eGFR(CKD-EPI) (β Coef. 0.344), age (β Coef.-0.318) and adjusted PKV (β Coef. 0.11) were found to be independent predictors of 2yr eGFR (CKD-EPI) (p<0.001).

Conclusions: Preservation of residual renal function in living donors needs to take into account remaining kidney volume, when selecting kidneys from healthy donors. To our knowledge this the first study to show the effect at 2 years post-donation using pre-donation remaining kidney volume and its relationship using the CKD-EPI equation.

To cite this abstract in AMA style:

Khalil A, Yaqub M, Taber T, Powelson J, Sundaram C, Goggins W, Mishler D, Mujtaba M, Diez A, Sharfuddin A. Preserved Kidney Volume in Living Kidney Donors: Correlation With 2 Year Renal Function Using CKD-EPI Equation to Predict Remaining GFR [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/preserved-kidney-volume-in-living-kidney-donors-correlation-with-2-year-renal-function-using-ckd-epi-equation-to-predict-remaining-gfr/. Accessed November 24, 2024.

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